Shoulder Range of Motion
Shoulder Range of Motion:
There are a few ways to assess shoulder range of motion, and in any joint for that matter! But today, we’re covering 3 types of range of motion, which are:
Active – This is where the client moves without any assistance from the practitioner.
Passive – A passive movement is where the practitioner moves the client’s arm without any assistance from the client.
Resisted: As the title suggests, this is where the client tries to move against the practitioner’s resistance.
Why does this matter?
The results and feedback you get from each type of motion can be really helpful in ascertaining what each individual’s restriction might be.
For example, if your client had pain or discomfort during an active as well as passive ROM then this would most likely suggest a joint issue. That’s not guaranteed but to be safe, a referral on for further investigation would be recommended. In the same way that if someone had no ability to actively move the joint, or they lacked the capacity to resist then you’d be looking at a neurological issue.
So it matters because it helps to narrow down why someone might have a shoulder issue. If it’s something that needs a referral then you’re potentially saving your client time in discomfort and moreover, you are safer in the knowledge that you’re not angering a condition which you are unable to improve through Pilates exercises alone.
It matters greatly to those who value happy clients!
Here is the full video for Shoulder Range of Motion – For those of you who like to read, we’ve also outlined the key points covered so you can follow along too! You can also visit our YouTube channel and subscribe to view all of the latest content!
In this video we look at the following movements:
- Flexion / Extension
- Abduction / Adduction
- External / Internal Rotation
Active Range of Motion (AROM):
In flexion, you’d be looking at a range of about 180° movement. In extension, you would be expecting around 60° of range. If someone doesn’t have this range, it’s not necessarily a fail on the screen – What you’re ultimately looking for is pain, or any asymmetry from arm to arm. Abduction should have an available range of movement of 180° and from an anatomical perspective, the movement should be lead by the thumbs.
Next you’d be looking at lateral rotation so asking your client to bend their arms to 90° with the palms facing inward and then rotating the arms outward. There should be 90° of movement here.
Medial rotation is next – in order to do that, ask your client to place the top surface of their hand behind their back. You can also test lateral rotation at the same time by asking your client to take the other hand above and behind the neck. You’ll be looking for asymmetries here and of course asking your client to let you know if they feel any pain or discomfort during any of these tasks.
Passive Range of Motion (PROM):
Sometimes its easier to have your client lying down for Passive ROM – It’s not essential but in our experience, they give you the arm more easily if they’re laying down and perhaps in a more relaxed positioning. In our video, we performed extension and internal rotation in standing and then took the rest with the client in supine. It’s important for the client to fully give you their arm and not assist you at all. You may have clients who are reluctant to relax and it’s really important to just continue cueing relaxation and being patient. It may take time for them to fully relax…
Similarly to AROM, we look at flexion, extension, abduction, adduction, internal and external rotation. In all of these screens, you’re feeling for restrictions, or reports of discomfort or pain. If you’re performing internal rotation when your client is supine, you’ll need to be looking at the humeral head – If it pops forward on internal rotation then you’ll know there is a restriction there. We’ll cover more about that in future posts!
Resisted Range of Motion (RROM):
This movement assesses strength – And you’ll hear Bonnie referring to the Oxford Scale. This is a graded scale from 1-5 and you’re really looking at results in the 4 to 5 ranges. The table below will help to explain what each grade equates to:
During the RROM screens, we recommend assessing your client’s ROM and then taking the arm to their midway range. For example, if your client has 180° of range, then you would take the arm to 90° and test the resisted strength there. This is because the muscles are at their optimum for strength midway through the range.
Interested in learning more?
…If you’re looking to learn more about the shoulder, we have our 2019 courses coming up over 2 weekends in 2 separate locations which are:
6th July in Ferndown
15th August in Gatwick
For more information you can either click here, or to book onto the course, please feel free to email us at firstname.lastname@example.org